Patient satisfaction and patient-centered care go beyond patient needs and incorporate what patients and their families perceive as quality of care. Effective communication between patients, patient families, and nursing staff, as well as staff efficiency and accessibility, play key roles in determining how patients view their stay at a hospital, eldercare facility or other in-patient health care facility (collectively, “health care facilities”), and whether they will recommend your facility to their friends and loved ones. Poor communication or miscommunication, as well as lack of staff attention are highly detrimental to patients' perception of quality of care.
Traditional facility management and recordkeeping methods are a source of many health care delivery problems and staff and patient complaints. Many facilities still utilize some offline recordkeeping, often on an ad hoc basis due to the hectic nature of health care facilities. These poor management practices may also be reflected in unfavorable reviews and reports, such as Press Ganey™ facility reports.
From the patient perspective, a significant source of complaints relate to poor communication. For example, patients may complain that the patient and his loved ones are not kept appraised of past, present and future treatment plans. In addition to being poorly informed regarding the patient's health care, sometimes it is not clear to the patient who should be contacted for this information. While patients and family members may know the name of the patient's primary physician—who may or may not be present in the facility—they may not know the name and contact information for the nurses or patient care technicians (PCTs) who have current responsibility for the patient's care. In other cases, patients and family members may not be aware of the patient's dietary restrictions or special needs. Patients may not be aware of upcoming treatment and scheduled tests for a specific date. Some patients may even be confused about where they are and what day and time it is.
From the institution's perspective, it is desirable to reduce the amount of administrative time used to create staff schedules and patient care notices, such as precaution notices. In health care settings, such information is contained in the unit staff board, which includes information regarding nurse/patient room assignments and information regarding patients' illnesses as well as special instructions for individual patients. This information typically must be displayed in an area restricted to staff personnel to comply with HIPAA rules. This information may not only include health information but also financial resource information as well.
Some precaution notices are also displayed in patients' rooms and/or outside patients' rooms. In some facilities, these room precaution notices—notices posted for patients having special issues—may be paper and may be taped or pinned to a corkboard or written on a dry-erase board. Typical precautions relate to allergies, fall risk, and possible infections. Creating such notices on an ad hoc basis is time-consuming and if such notices are not noticeable and legible, they may be overlooked by the staff, creating potential treatment issues. Unusual or nonstandard precaution notices may result in confusion among staffers. Similarly, paper and whiteboard notices are also vulnerable to alteration. Further, if notices for a given patient change, these changes may be logged for future reference. Precautions could even remain up after the patient for whom they were intended has been transferred or discharged, resulting in inappropriate treatment.
Other administrative issues relate to internal institutional recordkeeping. One purpose of such recordkeeping is to ensure that individual staff members are not being overworked. Another purpose of such recordkeeping is to ensure that particular tasks are being performed on a timely basis, such as rotating sedentary patients to avoid decubitis ulcers, which can result in reductions in payments through Medicare and Medicaid. The process of staff members making periodic patient visits/rounds is generally known as Hourly Rounding. Health care facilities may not necessarily integrate records of their hourly rounds into their electronic records.
One measure of patient satisfaction relates to the promptness of the staff in responding to patient calls. The time between a patient call and staff response must be monitored to ensure quality care.
Many facilities participate in Press Ganey™ surveys of patients, staff and physicians regarding a facility's performance. Poor reports by patients could result in a reduction in patient admissions and have an adverse effect on the finances of the health care facility. There is a need to improved provision of information related to patients in health care facilities.